Novel echocardiography-based algorithms to identify severe aortic or mitral regurgitation by cardiac magnetic resonance imaging: a prospective multi-modality imaging study. (3rd October 2022)

• Record Type: Journal Article
• Authors: Wang, T K M; Grimm, R A; Popovic, Z B; Rodriguez, L L; Bolen, M A; Chann, N; Moennich, L A; Rutkowski, K; Griffin, B P; Flamm, S D; Kwon, D H
• Is Part Of: European heart journal. Volume 43(2022)Supplement 2
• Publication Date: 2022-10-03
• Subjects: Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehac544.331
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Background: Magnetic resonance imaging (MRI) has shown incremental prognostic value to transthoracic echocardiography (TTE) for valve diseases, however TTE remains more widely available and utilized. We sought to develop TTE-based algorithms that best identify severe AR and MR by MRI in a prospective study. Methods: Patients with >moderate-to-severe AR (n=101) and MR (n=71) undergoing both TTE and CMR within 3-months (median 1 day) were prospectively studied. Correlation analyses were performed, and TTE-based decision tree regression algorithms were derived to best identify CMR-defined severe AR and MR (regurgitant fraction >40% and >33% respectively). Results: Mean regurgitant volumes/fractions by TTE were 15 mL/18% and 13mL/18% higher than CMR in AR and MR respectively. Decision-tree analyses found regurgitant volume >50 mL and left ventricular end-systolic volume indexed >38 mL/m 2 by TTE to best identify CMR-derived severe AR, and regurgitant fraction >50% and left ventricular stroke volume indexed >39 mL/m 2 by TTE to best identify CMR-derived severe MR (Figure 1). Their areas under curve compared with current guidelines criteria were 0.75 versus 0.63 (P=0.038) for severe AR, and 0.80 versus 0.67 (P=0.017) for severe MR. Conclusion: Novel TTE-based algorithms were devised to identify severe MRI-derived AR and MR, superior to the more complex multi-parametric criteria of current TTE guidelines. Funding Acknowledgement: Type of funding sources: None.